Hair Matters: Emotional Aspects of Hair Loss
Our hair is a vital part of our identity. The way our hair weaves, curls, shines, and flows says a bit about who we are and how we want to express ourselves.
Hair Loss Is Particularly Impactful in Women
Hair loss is a struggle for both men and women. However, for women, it can be particularly devastating. In one study that compared the psychological effects of hair loss in men and women, 52% of women felt extremely distressed while only 27% of men felt extremely distressed. Hair loss has an impact on personal confidence too, as the same study showed that 53% of women who experience hair loss felt less physically attractive and 65% felt less sexy. Generally speaking, men seem to be affected less, as hair loss caused only 35% of men to feel both less physically attractive and less sexy. The important take away is that while both women and men experience hair loss, they experience it differently.
The emotional toll from hair loss goes beyond skin deep. Hair loss affects quality of life in other areas like personal relationships, work, school, and basic daily activities. Physicians and dermatologists need to ask about these factors, rather than simply diagnosing and treating the scalp and hair. There are many negative emotions and feelings that come with hair loss, and these must be acknowledged by physicians to care for patients holistically.
Clinical Considerations with Hair Loss
Fatigue can be a sign of other factors since a poorly functioning thyroid can lead to hair loss, as can low iron levels from anemia. Examination of thyroid function or ferritin levels may be warranted.
Weight gain may be a sign of other health issues such as hypothyroidism. In some cases, weight gain coupled with hair loss may be an early sign for polycystic ovarian syndrome.
Hair loss can lead to depression and anxiety that, in turn, may worsen hair loss. For this reason, it’s important for practitioners to question patients about difficulty concentrating, a feeling of emptiness or loss of self-worth, difficulty enjoying activities that were previously enjoyable, trouble sleeping, or trouble with sexual life.
Hair Affects Confidence
Hair loss can affect our sense of style and social confidence in profound ways. Patients are affected at a much deeper level than the hair itself and patients should be addressed for their psychological needs as much as their clinical needs. Sometimes, just acknowledging the psychological distress makes all the difference in building the patient-doctor bond.
- Cash TF, Price VH, Savin RC. Psychological effects of androgenetic alopecia on women: comparisons with balding men and with female control subjects. J Am Acad Dermatol.1993;29(4):568-575; PMID: 8408792.
- Cartwright T, Endean N, Porter A. Illness perceptions, coping and quality of life in patients with alopecia. Br J Dermatol.2009;160(5):1034-1039; PMID: 19183424.
- Hadshiew IM, Foitzik K, Arck PC, et al. Burden of hair loss: stress and the underestimated psychosocial impact of telogen effluvium and androgenetic alopecia. J Invest Dermatol.2004;123(3):455-457; PMID: 15304082.